Temporary flexibilities and changes run from Dec. 1, 2022, to March 31, 2023.
Topics Related to Division of Health Benefits
Please post in a prominent location such as patient waiting rooms as soon as possible.
NCDHHS will delay the implementation of North Carolina Standard Plan and Tailored Plan Tobacco-Free Policy requirements.
Effective with date of service August 31, 2022, Medicaid and NC Health Choice cover Pfizer-BioNTech COVID-19 Vaccine
Effective with date of service Aug. 31, 2022, Medicaid and NC Health Choice programs cover Moderna COVID-19 Vaccine
Providers are encouraged to review for an overview of other general language and formatting updates.
All fee schedules currently listed on the NC Medicaid website have been moved to a new Fee Schedule and Covered Code Portal available to the public.
Effective Oct. 1, 2022, Pluvicto must be billed with HCPCS code A9607
Updated HCPCS Code, unit of coverage and maximum reimbursement rate
Key milestones, playbook updates, beneficiary eligibility, reverification, provider records, provider ombudsman, help center and webinars.